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Titolo:
Therapeutic developments in multiple sclerosis
Autore:
Goodin, DS;
Indirizzi:
Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
EXPERT OPINION ON INVESTIGATIONAL DRUGS
fascicolo: 4, volume: 9, anno: 2000,
pagine: 655 - 670
SICI:
1354-3784(200004)9:4<655:TDIMS>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLACEBO-CONTROLLED TRIAL; STATUS SCALE EDSS; CLINICALLY ISOLATED SYNDROMES; ACUTE OPTIC NEURITIS; INTERFERON-BETA; DOUBLE-BLIND; NATURAL-HISTORY; RELAPSE RATE; COGNITIVE DYSFUNCTION; FUNCTIONAL-SYSTEMS;
Keywords:
clinical trials; cytotoxic; dose effect; glatiramer acetate; immune; immunomodulatory; immunosuppressive; IFN-beta; intravenous gamaglobulin; multiple sclerosis; plasma exchange; treatment;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
80
Recensione:
Indirizzi per estratti:
Indirizzo: Goodin, DS Univ Calif San Francisco, Dept Neurol, M-794, San Francisco, CA94143 USA Univ Calif San Francisco M-794 San Francisco CA USA 94143 3 USA
Citazione:
D.S. Goodin, "Therapeutic developments in multiple sclerosis", EXPERT OP I, 9(4), 2000, pp. 655-670

Abstract

Recently there have been considerable advances made in the treatment of multiple sclerosis. For the first time since its initial clinical descriptionin the 1800s, there are now available several medications which unequivocally exert favourable clinical effects through the lowering of the biological activity of die human illness. The therapeutic efficacy of IFN-beta preparations seems particularly well established in this regard on the basis of five large, independent, trials of this agent. These: trials have demonstrated remarkably consistent reductions in both attack rates and disability levels using a combination of clinical and magnetic resonance imaging outcomemeasures. The therapeutic benefit of glatiramer acetate also has been wellestablished, although there is less available data on this agent than there is for interferon. It is important to recognise, however, that, although these agents represent an important first step in the management of patients with multiple sclerosis, they are only partial therapies. In order to actually cure the illness or even to substantially improve patient outcome pieneed considerably better agents than we have currently. Nevertheless, it is likely that, with improved knowledge of the role that interferon beta plays in the pathogenesis of multiple sclerosis and with better understanding of the mechanism by which glatiramer acetate exerts its therapeutic: effect, greatly improved therapeutic agents will be available in the future. In addition, it seems likely that, in the future (by analogy to the experience in oncology), we will begin utilising combinations of therapies in order tobetter control it the biological activity of this debilitating disease. Such combination therapy well almost certainly include combinations of partially effective agents as well as combinations of these agents with other medications (e.g., the immunosuppressive drugs) which, by themselves, have only been demonstrated tu exert marginal clinical benefits on the course of illness. Moreover, it also seems likely that, increasingly, therapeutic strategies that enhance or promote myelin repair will become a major focus of clinical research in this area.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 16:56:04